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Ethical guidelines for organ transplantation from deceased donors submission

Submission ID: 
2
This submission reflects the views of
Organisation Name: 
Organ Donation & Transplant Foundation of WA
Please identify the best term to describe the Organisation: 
Non-government organisation
Personal Details
Submission - Option 1. Online submission
Specific Comments: 
1.1 Who is eligible for transplantation?

General Comments

Section 1.1 of the Ethical guidelines for organ transplantation from deceased donors provides a very generalised summary on eligibility for transplantation and must be read in conjunction with the Consensus Statement for a more specific and detailed outline of specific inclusion and exclusion criteria for eligibility of transplantation.

Recommendation

In relation to the above section, we make the following submission for inclusion in the Ethical guidelines for organ transplantation and amendment to the Consensus statement on eligibility criteria and allocation protocols

I refer to section 1 of Consensus statement on eligibility criteria - General incusion and exclusion criteria page 2

This section states that "All patients assessed for suitability for a transplant have the right to know whether or not they are placed on the waiting list, and the reasons why they are not listed if they are evaluated as unsuitable."

It is our strong recommendation that;

1. That reasons for being evaluated as unsuitable must be provided IN WRITING to the patient concerned within one month of evaluation decision

2. That written notification of the evaluation outcome must be provided to the patient and signed off by at least two medical professionals involved in the assessment process.

3. That the two health professionals providing sign off on written notification to patient, must have delegated authority from the multidisciplinary transplant team responsible for the evaluation and assessment process.

4. In the case of the multidisciplinary transplant team not being able to come to a unified decision on the suitability of a candidate for transplantation, a 75% majority must be recorded before a person is deemed unsuitable for transplantation.

If a 75% majority is not recorded by all members of the multidisciplinary transplant team making the assessment, then the patient MUST be referred to an alternative Australian Transplant Unit for a second opinion.

 

1.3 How are organs allocated?

General Comments

Section 1.3 provides a detailed outline of the complexities involved in the organ donation allocation process, and adequately addresses the varied range of factors that impact the overall process.

Recommendation

The following recommendation relates to the allocation of higher risk criteria organs.

1. That every patient evaluated as being unsuitable for transplantation and listing on the main cadaveric donor list, must be automatically and assessed for higher risk organ criteria organs. 

2. Assessment of a patient for higher risk criteria organs must be with patients full consent and knowledge, together with full disclosure of associated risks vs benefits.

3. Full disclosure of all associated risks to patient must be present at all times during the process.

4. Upon identification of a suitable higher risk criteria organ for transplantation, full disclosure must be provided to patient in relation to the higher risk criteria organ and written consent obtained from the patient confirming that;

a: The patient has been made aware that they are accepting a higher risk criteria organ

b: The associated risks and benefits of accepting a higher risk organ have been discussed prior transplantation and the patient accepts these risks and is willing to recieve a higher risk criteria organ.

 

Page reviewed: 8 April, 2016